Author: Meghan Barrett

Now Open: 2024 NABH Annual Meeting Registration!

Registration is now open for the 2024 NABH Annual Meeting, The Future of Behavioral Healthcare. Please join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting to examine and discuss critical issues that behavioral healthcare providers manage today and will continue to address tomorrow, including access to care, parity, technology, workforce, the political environment, and more. Click here to register for the meeting and reserve your hotel room. We look forward to seeing you in Washington!

SAMHSA and ONC Launch Behavioral Health Information Technology Initiative

HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) and Office of the National Coordinator for Health Information Technology (ONC) this week announced they will invest more than $20 million of SAMHSA funds in the next three years to advance health information technology (IT) in behavioral healthcare and practice settings. The announcement acknowledged that behavioral healthcare providers lag behind other providers in health IT adoption in part because they are ineligible to participate in health IT incentive programs that the Centers for Medicare & Medicaid Services (CMS) provide. An ONC analysis of American Hospital Association survey data from 2019 and 2021 found that 86% of non-federal, general acute care hospitals had adopted a 2015-edition certified electronic health record (EHR), while only 67% of psychiatric hospitals had adopted the same certified EHR. Meanwhile, ONC analysis of SAMHSA survey data from 2020 show psychiatric hospitals lag even further behind in adoption of interoperability and patient engagement functions. To address these challenges, the Behavioral Health Information Technology (BHIT) Initiative will identify and pilot a set of behavioral health-specific data elements with SAMHSA’s Substance Use Prevention, Treatment, and Recovery Services Block Grant and Community Mental Health Services Block Grant grantees and Community Mental Health Services Block Grant grantees. The data elements will be coordinated via a new USCDI+ domain for behavioral health to improve the effectiveness and reduce the costs of data capture, use, and exchange for behavioral health providers. This year ONC, SAMHSA, and other federal partners will begin to identify data elements for the USCDI+ project as part of the broader BHIT Initiative. This collaborative approach will incorporate input on behavioral health priorities from a variety of individuals and entities including clinicians, grantees, states, and advocates. Then SAMHSA and ONC will coordinate with technology developers and participating providers on how to best include USCDI+ behavioral health data elements in health IT and pilot their use.

HHS Finalizes ‘42 CFR Part 2’ Rule to Better Align with HIPAA Standards

HHS on Thursday released its final Confidentiality of Substance Use Disorder (SUD) Patient Records rule to implement the Coronavirus Aid, Relief, and Economic Security Act (CARES) amendments to the federal substance use confidentiality rule – commonly known as 42 CFR part 2, or Part 2. Consistent with NABH recommendations, the new rules further align Part 2’s requirements with the Health Insurance Portability and Accountability Act’s (HIPAA) rules and the Health Information Technology for Economic and Clinical Health Act (HITECH). Although opponents to these changes argued they were unnecessary, HHS nonetheless adopted these modifications to align with HIPAA, a rule that has historically had fewer privacy protections than part 2. The new rule permits patients to provide one-time consent for the disclosure of treatment records; permits an accounting of disclosures; strengthens prohibitions against disclosure of records in civil, criminal, or legislative proceedings, and provides HHS with enforcement authority, including financial penalties. Importantly, the rule creates a new definition for SUD clinicians’ notes that is analogous to the protections HIPAA provides for psychotherapy notes. The rule will become effective 60 days after publication and compliance is not required until 2026. Meanwhile, HHS’ Office for Civil Rights plans to finalize changes to the HIPAA Notice of Privacy Practices (NPP) to address uses and disclosures of protected health information that is also protected by Part 2 along with other changes to the NPP requirements, in an upcoming final rule modifying the HIPAA privacy. In addition, HHS plans to implement in separate rulemaking the CARES Act antidiscrimination provisions that prohibit the use of patients’ Part 2 records against them.

CMS Releases Updated State Medicaid & CHIP Telehealth Toolkit

CMS this week released an updated State Medicaid & Children’s Health Insurance Program (CHIP) Telehealth Toolkit, a series of resources that include telehealth policies and information about telehealth platforms, billing best practices, strategies to deliver accessible and culturally competent care via telehealth, and more. The resources provide states with statutory and regulatory infrastructure issues to consider as they evaluate the need to expand their telehealth capabilities and coverage policies, including coverage and reimbursement policies, providers, and practitioners eligible to provider telehealth, technology requirements, considerations for specific populations, and state examples and strategies.

Prevent Suicide New Jersey to Host Safety Planning Intervention Workshop on Feb. 28

Prevent Suicide New Jersey, a partnership among state departments, professional and community organizations, schools, and families, will host a free workshop on Feb. 28 about the Stanley Brown Safety Planning Intervention (SPI), a collaborative, clinical intervention that results in a prioritized written list of warning signs, coping strategies, and resources for suicidal individuals. The virtual workshop will teach participants the six steps to create a safety plan: 1) recognizing warning signs; 2) identifying internal coping strategies; 3) identifying other people or social settings for distraction; 4) identifying individuals to ask for help; 5) identifying professionals and agencies for help; and 6) making the environment safe. The New Jersey Chapter, American Academy of Pediatrics (NJAAP), ABFT International Training Institute, LLC, and the U.S. Journal of Training are co-sponsoring the training, and the webinar is open to certified licensed community behavioral health clinicians, school-based behavioral health providers, and interested community members. Click here to register.

Reminder: Please Submit Data to NABH’ Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

Researchers at the University of Texas at Austin, the University of Texas at Dallas, and the University of Miami have identified a molecule that reduces hypersensitivity in trials in mice by binding to a protein they have shown is involved in neuropathic pain, according to a study published in Science Daily. The new compound, dubbed FEM-1689, does not engage opioid receptors in the body, making it a possible alternative to existing pain medications linked to addiction.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Alert: SAMHSA Updates OTP Regulations

The Substance Abuse and Mental Health Services Administration published Medications for the Treatment of Opioid Use Disorder late yesterday for public inspection. The final rule was published earlier today and becomes effective on April 2, 2024, with compliance by October 2, 2024. [Please note that this is a correction of the compliance date of October 2, 2026 that was published yesterday in the public notice.] NABH provided comments on the Notice of Proposed Rule Making that was issued in December 2022 calling for greater regulatory flexibility for opioid treatment programs (OTPs). The final regulations align closely to NABH recommendations and herald greater deference to clinical decision-making in the nation’s (OTPs). Among the provisions, the regulations:

• Make permanent the Covid-era take-home schedule;
• Permit methadone for new patients via audio-visual telemedicine with the dispensing of medication at the OTP (not audio-only).
• Permit audio-only telemedicine when the patient is in the presence of a practitioner who is registered to prescribe SII, including dispensing.
• Clarify (in response to NABH off-line discussion and official comments) that the prescription of methadone to community pharmacies is NOT permitted;
• Change the requirement for a one-year history of OUD for eligibility so that now either the patient must a) meet diagnostic criteria for moderate-severe OUD, or b) be in OUD remission, or c) at high risk for overdose;
• Remove the requirement for two treatment failures for people under 18 to be eligible for services;
• Remove requirement for a one-year history of OUD for people recently released from a correctional facility, pregnant patients, or previously enrolled individuals;
• Allow medication units to provide all OTP services;
• Decouple medication and attendance at counseling services;
• Permit interim treatment for 180 days, including at for-profit OTPs;
• Permit mid-levels (“…those appropriate licensed by the state”) to prescribe without exemption;
• Clarified accreditation standards to reduce potential for a burdensome increase in less-than 3-year accreditations;
• Permit buprenorphine prescribing in an OTP via audio-only and audio-visual without an in-person evaluation; and
• Update terminology to reflect contemporary, non-stigmatizing language.

The final rule additionally codifies the Consolidated Appropriations Act, 2023 elimination of the Drug Addiction and Treatment Act (DATA) Waiver by removing all relevant language.

CMS Proposes MA Rates for 2025

The Centers for Medicare & Medicaid Services (CMS), on Wednesday, released a calendar year (CY) 2025 advance notice which includes measures related to Medicare Advantage (MA) and other issues. The advance notice proposes an annual increase to MA payments of, on average, 3.7 percent ($16 billion), relative to 2024. This advance notice complements another CY 2025 proposed rule issued last November. It also builds upon technical updates in 2023 to the MA risk adjustment model that are designed to yield more accurate payments. CMS will accept comments on the advance notice through April 1. For additional background, see this CMS fact sheet. NABH appreciates CMS’s meaningful efforts in recent years to improve the MA program, including increasing the accountability and transparency of MA health plans as well as substantive proposals to enforce parity and improve the prior authorization program.

CMS Requests Information on MA In Push For Data Transparency

The Centers for Medicare & Medicaid Services (CMS), on Thursday, Jan. 24, requested information on Medicare Advantage (MA) data capabilities to increase data transparency. The RFI asked for recommendations for improving data capabilities to increase accuracy on coverage, enhance quality of care, and better inform healthcare professionals. This RFI builds upon CMS’ extensive regulatory activity to increase transparency and accountability of Medicare Advantage plans. CMS is aiming to have comprehensive data on the MA program made publicly available and thus allowing for further comparative analyses between other health programs. Click here to read the full press release.

SAMSHA Releases Guide for Overdose Prevention and Response

The SAMHSA Overdose Prevention Toolkit provides guidance on preventing and responding to an overdose and the role of opioid overdose reversal medications. The toolkit emphasizes that harm reduction and access to treatment are essential aspects of overdose prevention. Appendices are directed to specific audiences, such as people who use drugs (PWUD), people taking prescribed opioids, first responders, healthcare practitioners, and others. Click here to access the toolkit.

GAO Evaluates the Potential Expansion of FHA Loans to Behavioral Health Hospitals

The Government Accountability Office last week issued recommendations to Congress on the pros and cons on the possible expansion of the Federal Housing Authority (FHA) Hospital Mortgage Insurance Program. Any expansion in the future would expand access to higher-acuity behavioral health services. Today, this FHA program funds loans to general acute-care hospitals for capital improvements, not including hospitals focused on treating behavioral health patients due to their, on average, smaller size, revenue, and margins. The report, commissioned by Congress, suggests that any expansion of this program be coupled with parameters to mitigate potential risks, such as initially limiting the volume loans to newly eligible hospitals through a pilot program, and requiring regular loan performance updates from FHA to Congress

SAMHSA Offers Consumer Guide for Peer Support in Substance Use Recovery

The newly released peer support recovery guide from The Substance Abuse and Mental Health Services Administration (SAMHSA) provides an in-depth look into the role of peer specialists. SAMHSA states that readers can utilize visual aids and consumer forms to better understand the range of services provided by peer specialists and how they can be a resource to those in recovery from substance use. Click here to access the guide.

HHS’ Office of Long Covid Welcomes Ian Simon as Director

The Department of Human and Health Services (HHS) appointed Ian Simon as the director of the Office of Long Covid Research and Practice. In this position, Simon will lead HHS towards a coordinated government response to better understand the long-term impacts of COVID-19. Simon was the assistant director for health strategy and bio preparedness at the White House’s Office of Science and Technology Policy. He also brings additional experience from his time at the National Institute of Allergy and Infectious Diseases (NIAID).

Reminder: SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February.

Fact of the Week

A study from JAMA Internal Medicine found that pregnant patients treated with buprenorphine within the first trimester had an 18% lower risk of congenital malformations than those treated with methadone.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS $50 Million in Grants for School-Based Health Services, Particularly for Mental Health

The Centers for Medicare & Medicaid Services (CMS) this week announced $50 million in state grant funding to connect millions more children to critical healthcare services, especially mental health, in schools. The funding comes through the Bipartisan Safer Communities Act and will provide 20 states up to $2.5 million each in funding that can help states implement, enhance, and expand school-based health services through Medicaid and the Children’s Health Insurance Program, or CHIP. “This funding will be transformational for states at any stage in developing school-based health services programs, which represent one of CMS’ most powerful tools for expanding access to care for our children,” CMS Administrator Chiquita Brooks-LaSure said in an announcement about the funding. “Medicaid and CHIP cover over 39 million children. This targeted support is one way CMS can help kids get the health care they need by meeting them where they are — in school.” CMS said it anticipates a total of 20 grant awards, with a minimum of 10 awards to states that have yet to cover school-based health services for all children covered under Medicaid or CHIP. In addition, the agency said up to 10 grants are intended for states that have taken initial steps to expand school-based health services, with the hope that these grants will enhance or refine their existing programs. Applications for grant funding are due by March 25 and funding is expected by this summer. Click here for more information.

National Academy for State Health Policy Updates State Opioid Settlement Tracker

The National Academy for State Health Policy (NASHP) this month updated its tracker to show how states are implementing administrative structures to disburse an expected $50 billion awarded to states and localities from opioid-related lawsuits, which includes $26 billion awarded to 46 states as part of the National Opioid Settlement. These structures include strategies for engaging a wide variety of stakeholders on priorities for reducing opioid-related deaths and investing in SUD prevention, treatment, and recovery infrastructure. NASHP released an issue brief about its tracker in December 2022 to show funding allocated to each state through the National Opioid Settlement, as well as laws, agreements, and processes that states have established for allocating the funds.

Now Available: NABH Education and Research Foundation Webinar Resources and Interview

Thank you to all who joined or watched our foundation’s webinar, Redesigning the Present and Future Behavioral Healthcare Workforce, on Tuesday, Jan. 23. NABH regrets that we were unable to hear from NABH Education and Research Foundation President and co-presenter Don Parker soon after the webinar began due to a power outage in Parker’s service area. Below is an exchange between Parker and co-presenter Beth Kuhn, principal at workforce consultancy Stonegate Strategies, in a post-webinar interview. BK: Don, what can you tell us about the top workforce challenges you experienced at Hackensack Meridian Health System? DP: At the start of the COVID-19 pandemic, the Hackensack Merdian Health System asked the system’s Behavioral Health Care Transformation Services to develop a post-pandemic strategy recognizing that we would have two major problems to deal with: a rapidly increasing demand for behavioral healthcare, given all of the fear, loss, isolation and uncertainty our citizens were experiencing, and an unpredictable reaction from our staff who had the same fears but just multiplied given the nature of their jobs in health care. Although we slowed our feared staff exodus, similar to every other hospital in America, it increased and has led to shortages across the professions. As we now face both supply (under staffing of all levels of professionals) and demand (unprecedented demand for behavioral health from every age cohort) our HMH team has turned its focus to improving retention and attracting new recruits to bolster our veterans. BK: Your system has been especially focused on building partnerships to support your talent supply efforts.  What can you tell us about your approach? DP: Knowing we would face a shortage of psychiatrists, HMH initiated 64 psychiatry resident slots and 16 fellowships (heavily weighted to children). Our first class graduated last year and began to fill our ranks.  For the many residents and fellows we recruited to stay at HMH, we engaged them in an “Earn While You Learn” program for their final year. They received what would be equal to a signing bonus in monthly increments for the year. It provided great recruitment and retention. Our health system created two new nursing school partnerships with all the nurses rotating through the HMH psychiatry locations. The exposure has proven to be highly beneficial to our nursing recruitment. On the Mental Health Technician front, we have initiated several programs in partnership with the Local Workforce Investment Boards and the Community Colleges. I have had more than a 30-year history of working closely with WIBs. I also served as chairman of the WIB in my county in New Jersey for several years. I have been a Board Member of the Community College in my County for 17 years and personally started my education in a Junior College. BK: One webinar participant asked for information on what “resiliency investments” look like. It seems to me that you have some answers within your overall retention strategy. DP: Our administrative staff were deeply concerned that we would experience an exodus of our staff due to the sheer everyday extreme stress they were experiencing. During the pandemic HMH engaged in multiple staff support strategies, from shortened schedules, on the spot individual and group counseling, integrative medicine delivered remotely or on the spot, as well every morale booster we could engage in. In addition, as a retention strategy, HMH has shifted to a Strength-based motivational system (our version of Strength-based therapy). We expect that the focus on creating a mindset as a Survivor as opposed to being a victim of the pandemic will have a major impact on improving retention. BK: Apprenticeship seems to hold a lot of potential, both in bringing more professionals into your system and in prompting workforce redesign.  Tell us about HMH apprenticeship efforts. DP: Our post-pandemic initiatives have featured two collaborations with Middlesex Community College in New Jersey and the WIB Board. In Fall 2023, we worked with Middlesex to develop and deliver a certification as a Mental Health Technician. While not specifically designated as an apprenticeship, it served the purpose, as the academics, designed in collaboration with the HMH staff, were delivered to the college, with the on-the-job at HMH Psychiatric Hospitals. HMH has engaged in designing a second MHT Certification with a specialization in Integrative medicine. Each of our four psychiatric inpatient hospitals at HMH provide a daily curriculum filled with options for patients to engage in relaxation exercises, music therapy, yoga, Qigong, exercise programs, and a substantial exposure to art therapy. We expect this initiative will expand our recruitment pool to all the integrative medicine providers who practice in the community and can blend their practices with a job that offers steady income and benefits.

Reminder: SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February.

Fact of the Week

Semaglutide, a highly popular medication that the U.S. Food and Drug Administration has approved to treat obesity and manage type 2 diabetes, was associated with a 49% to 73% lower risk of first-time or recurring suicidal ideations compared with other medications for controlling obesity and type 2 diabetes that work via different mechanisms, according to a recent NIH-funded study.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Education and Research Foundation to Kick Off Webinar Series Next Week

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as director of workforce development at the Vermont Department of Labor. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Kuhn and Parker, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please join us and click here to register for this free webinar!

Congress Clears Stop Gap Funding Extension, Delaying Potential Healthcare Package

Staving off a government shutdown, House and Senate lawmakers passed legislation this week to extend the federal government’s current funding deadlines into March. The House passed the bill in 314-108 vote hours after the Senate passed the measure 77-18. The legislation extends funding for agencies under four appropriations bills that were scheduled to expire today, Jan. 19 – Agriculture, Rural Development, Food and Drug Administration, and related agencies; Energy and Water Development; Military Construction, Veterans Affairs, and related agencies; and Transportation, Housing and Urban Development, and related agencies – until March 1. Funding covered under the remaining eight bills that were scheduled to expire Feb. 2 have been extended through March 8. Lawmakers have indicated they expect this is the final stopgap spending measure needed for fiscal year 2024. Several non-controversial healthcare provisions were included in the March 8 stopgap measure, such as providing continued funding for community health centers, teaching health centers and the National Health Service Corps; funding special diabetes programs; averting steep cuts to hospitals that have a high volume of uninsured and Medicaid patients; and providing continued funding for the Sexual Risk Avoidance Education Program, which aims to limit teen pregnancy and domestic violence. The bill did not address several expired health programs, including the SUPPORT Act reauthorization; the global HIV/AIDS program, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the Pandemic and All-Hazards Preparedness Act; and heath price transparency legislation. Lawmakers are expected to include those programs in a potential March deal, if Congress doesn’t have to punt again with another spending patch. NABH continues to advocate for SUPPORT Act reauthorization and to stop the Modernizing Opioid Treatment Access Act (MOTAA) as part of a broader healthcare package. Health policy leaders in the House and Senate remain in negotiations on a final package.

CMS Increases Prior Authorization Timeliness and Transparency in Final Rule

The Centers for Medicare & Medicaid Services (CMS) this week finalized a rule that takes concrete steps to shorten the prior authorization process, which physicians and providers use to request health plan coverage for medical treatments and services that a physician has prescribed for a patient. In part, this rule responds to recent government audits that found that many government-contracted health plans were denying coverage inappropriately for services that actually were covered. The rule mostly takes effect for managed contracts in 2026 and beyond for insurers who contract with Medicare, Medicaid, and the Children’s Health Insurance Program, but not private insurance. Specifically, health plans will be required to make prior authorization coverage decisions within seven days and 72 hours for urgent requests. The rule also requires health plans to provide a specific reason for denying a prior-authorization request, which will help facilitate the correction of fixable claims as well as denial appeals. These payers also will be required to report their clinical and/or policy basis publicly for prior-authorization denials. Finally, to further reduce administrative burden, payers will now be required to conduct prior authorizations using a common electronic interface for transactions and data exchange, using Health Level 7 and other applications. Overall, CMS estimates that the final rule will reduce federal healthcare expenditures by approximately $15 billion over 10 years. Click here to learn more in the agency’s fact sheet.

CMS Announces Model to Test Approaches for Advancing Integration in Behavioral Health

CMS on Thursday introduced its Innovation in Behavioral Health (IBH) model to improve the care quality and outcomes for adults with Medicare and Medicaid who have mental health conditions and/or substance use disorder (SUD) by connecting them with the physical, behavioral, and social supports they need. The CMS Innovation Center will test the new IBH model, under which community-based behavioral healthcare practices will form interprofessional care teams composed of behavioral and physical health providers, as well as community-based supports. This new model supports President Biden’s mental health strategy and implements an action item in the HHS Roadmap for Behavioral Health Integration.   “The Biden-Harris administration will continue to explore innovative ways to help people with mental health conditions and/or substance use disorder,” HHS Secretary Xavier Becerra said in an announcement. “Put simply, mental health is health—and by expanding access to the high-quality care that people need, we are changing lives.” CMS’ announcement said through the interprofessional care teams, people will experience an integration of services that will bridge the gaps between physical and behavioral health. The model enables a “no wrong door” approach, meaning that regardless of how patients enter care, they will have access to all available services. Through this practice, IBH also aims to reduce overall program expenditures. The model will launch in Fall 2024, and CMS said it expects it to operate for eight years in up to eight states. CMS will release a notice of funding opportunity for the model in Spring 2024. Click here to learn more.

SAMHSA Releases Updated 988 Partner Toolkit

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an updated 988 Partner Toolkit that the agency says is designed to help users better navigate the bank of materials available to promote the lifeline in communities. The toolkit has the same video PSAs, social media promotions, FAQs, and print materials, and is now available to search by target audience, population, language, and resource type. Click here to access the toolkit.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s Annual Meeting, The Future of Behavioral Healthcare. Registration will open in February. Fact of the Week SAMHSA’s Food and Mood Project aims to promote emotional wellness and reduce the impact of mental health and substance use conditions among the nation’s K-12 population by implementing strategies that address the intersection among behavioral health, food/nutrition security, and cultural food diversity.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

Congress Returns to Urgent Funding Deadlines and Full 2024 Agenda

Congress returned to Washington this week facing two deadlines to fund all federal government operations as it works to clear some policy priorities – including a healthcare package with the SUPPORT Act’s reauthorization – ahead of the 2024 campaign season. In early January, House Speaker Mike Johnson (R-La.) and Senate Majority Leader Chuck Schumer (D-N.Y.) agreed to topline funding figures, allowing congressional appropriations leaders to begin the process of negotiating each of the spending allocations for all 12 spending bills. Congress has until Jan. 19 before the first government funding deadline for the U.S. Agriculture, Energy, Housing and Urban Development, Transportation, and Veterans Affairs Departments. All other departments, including HHS, are funded through Feb. 2. There is a growing likelihood that Congress will have to pass a short-term continuing resolution (CR) to allow lawmakers to agree on funding, although conservative House members are strongly opposed to that action and threaten to derail progress. Congressional leaders have indicated a healthcare package will likely be included in the first funding bill, due to the urgency in addressing several expired health programs and funding provisions for physician payments. This package will include several healthcare bills the House and Senate have passed.   NABH continues to advocate strongly for the SUPPORT Act’s reauthorization with new provisions and opposes the Modernizing Opioid Treatment Access Act (MOTAA), which only the Senate HELP Committee has passed and the House has not considered. MOTAA proponents are strongly advocating for this bill to be included in the final package, and NABH and coalition partners are working with both congressional chambers to prevent this effort. This advocacy includes working with members of the Senate HELP Committee who oppose MOTAA to continue raising concerns with their Senate leadership; contacting members who serve on the Senate Judiciary Committee; contacting other senators who share concerns with law enforcement officials about implementing this legislation; as well as contacting members of the House Energy and Commerce Committee and House Judiciary Committee. House Energy & Commerce Republicans remain strongly opposed to including MOTAA in any legislative package. NABH continues to emphasize to Members of Congress that there is no consensus on MOTAA and these policies need more vetting. Other health policies that lawmakers might fold into a larger legislative package include addressing expired telehealth regulations, Medicare’s physician pay cut, transparency measures, reporting requirements for insurers, hospitals and pharmacy benefit managers, and site-neutral payment provisions. In addition, funds for graduate medical education, community health centers, and special diabetes programs sunset on Jan. 19, and certain Medicaid disproportionate share hospital cuts are delayed until that date. NABH will continue to support provisions important to our members and fight to prevent bad policies from becoming law. Please see next week’s edition of CEO Update for the latest information.  

NABH Education and Research Foundation to Host Workforce Webinar on Jan. 23

Please join us for the NABH Research and Education Foundation’s first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please click here to register for this free webinar and share the link with members of your teams!

CMS Administrator Brooks-LaSure to Outline Agency’s 2024 Priorities in Stakeholder Call

The Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure will host a stakeholder call to discuss the agency’s 2023 accomplishments, 2024 priorities, and CMS Strategic Plan on Tuesday, Jan. 23. CMS Principal Administrator and Chief Operating Officer Jon Blum and other members of the CMS leadership team will also serve as presenters during the hourlong call, which will begin at 1 p.m. ET. Click here to register.

CMS Releases State Plan Summaries for American Rescue Plan of 2021

CMS has released state spending plan summaries for a section of the American Rescue Plan of 2021 (ARP) that provides information about the amount of money spent on activities to enhance, expand, or strengthen community-based services. NABH members might find the report useful because it includes information about state spending on efforts related to workforce, technology, education, behavioral healthcare support for youth, housing and homelessness, and more. Click here for the full report and to read your state’s summary.

Save the Date for the NABH 2024 Annual Meeting!

Registration will open soon for the NABH 2024 Annual Meeting, The Future of Behavioral Healthcare, at the Salamander Washington, DC from May 13-15, 2024. Please plan to join us!  

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

About 52,000 Medicare enrollees experienced an opioid overdose in 2022; however, only 18% of Medicare patients with opioid use disorder received medication-assisted treatment, according to a report from the HHS Office of the Inspector General. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Welcomes Frank Ghinassi, Ph.D. as 2024 Board Chair

NABH is pleased to welcome Rutgers University Behavioral Health Care (UBHC) President and CEO Frank Ghinassi, Ph.D. as chair of the NABH Board of Trustees for 2024. A longstanding NABH member, Frank has served the association in many capacities, including as board treasurer, Quality Committee chair, and Annual Meeting program chair. As UBHC’s CEO, Frank is responsible for a statewide system of academically based mental health and addiction services across New Jersey; managing an annual operating budget of $320 million and 2,200 staff and faculty. UBHC, one of the largest providers of behavioral and addictions healthcare in the country, offers a wide range of clinical services across all diagnosis, and across the lifespan, including inpatient units, partial hospitalization programs, intensive outpatient programming, case management, traditional outpatient treatment, correctional health care, a Certified Community Behavioral Health Center, peer operated helplines for service members, veterans, mothers of children with special needs, law enforcement officers and child protection workers, a statewide suicide prevention hotline and a clinical research and training institute, as well as an array of specialty and peer support services. Frank also serves as professor at Rutgers Graduate School of Applied and Professional Psychology; an adjunct professor of psychiatry at Rutgers Robert Wood Johnson Medical School; an adjunct associate professor of psychiatry at the University of Pittsburgh School of Medicine; and a core faculty member at Rutgers Global Health Institute. The association’s Washington-based team is eager to work with Frank this year and appreciates his vision and leadership. NABH is also grateful to Sheppard Pratt President and CEO Harsh Trivedi, M.D., M.B.A. for his service as the association’s 2023 board chair and all he has done to promote NABH, its priorities, and its mission. Thank you, Harsh!

NABH Letter to CMS Cites Concerns about Medicare Advantage Plans that Block Access to Care

NABH this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns about Medicare Advantage (MA) plans that either block or delay access to behavioral healthcare services. The association’s letter endorsed and also made recommendations related to the rule’s positive provisions, such as incentivizing MA coverage for additional behavioral healthcare practitioners and inclusion in a health plans’ provider networks; annually analyzing the health equity level of MA plans relative to underserved populations; and laying the groundwork for increased data collection on MA coverage decisions, appeals and decision rationales. NABH’s letter also urged CMS to modify its existing proposal to improve the appeals process for MA enrollees in certain settings to include behavioral healthcare settings, which the letter describes in detail.

Sen. John Fetterman Discusses His Battle with Depression on NBC’s ‘Meet the Press’

In an exclusive interview with NBC News’ “Meet the Press” on Dec. 31, Sen. John Fetterman (D-Pa.) spoke candidly about his experience with clinical depression and how he is grateful for receiving treatment. The first-term senator was discharged March 31 from Walter Reed National Medical Center, where he had received treatment for clinical depression. Fetterman checked himself in for treatment on Feb. 15 last year following a battle with depression that worsened during his recovery from a stroke he suffered in May 2022. “The line [is] ‘I’m living my best life,’ and I really am, because I just am so grateful,” Fetterman told journalist Kristen Welker. “And I’m always talking about mental health because I want everybody that can hear that is that help works, and you should get help. And please, don’t suffer any longer, because you deserve to be better. And I’m so grateful to do that, and I’m paying it forward by talking about it.” Click here to watch Fetterman’s interview.

NABH Education and Research Foundation to Host Workforce Webinar on Jan. 23

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. NABH Education and Research Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. Throughout this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. The Foundation will also ask attendees poll questions during the hourlong webinar to gauge member interest in future workforce events and resources. Please join us and click here to register for this free webinar!

National Academies to Host Webinar on Behavioral Healthcare Provider Experience with Public Insurance Programs Next Week

The National Academies’ Committee on Strategies to Improve Access to Behavioral Health Care Services through Medicare and Medicaid will host a virtual webinar that discusses behavioral healthcare provider experiences with public insurance programs on Wednesday, Jan. 10. This webinar will examine the experiences of behavioral healthcare providers who accept Medicare, Medicaid, and Marketplace insurance and discuss what can be done to increase access to behavioral healthcare services for this patient population. Click here to register for the two-hour webinar, which starts at 2 p.m. ET next Wednesday.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for this year’s NABH Annual Meeting!

Fact of the Week

A new study in Psychiatry Research suggests ethnoracial inequities in patient assignment to buildings that differed in clinical and physical conditions. Examining data from more than 18,000 unique patients during a period of six years, researchers said the findings serve as a call to action for hospital systems to examine the ways in which structural racism impact clinical care.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Education and Research Foundation to Host Workforce Webinar in January

The NABH Education and Research Foundation is pleased to host its first webinar, Redesigning the Present and Future of Behavioral Healthcare, on Tuesday, Jan. 23, 2024 from 2 p.m. – 3 p.m. ET. Foundation President Donald Parker, who serves as president of Behavioral Health Care Transformation Services for Hackensack Meridian Health, will co-lead the webinar with workforce consultant Beth Kuhn of Stonegate Strategies. Kuhn has more than 30 years of workforce experience – with special interest and expertise in behavioral healthcare workforce development – and has served in both Democratic and Republican administrations, including in her roles as commissioner of the Kentucky Department of Workforce Investment and as Vermont’s director of workforce development. Kuhn’s accomplishments include creating the Strategic Initiative for Transformation Employment, or SITE, a statewide model designed to bridge the gap between recovery and workforce participation for individuals active in their recovery from substance use issues. During this interactive webinar, participants are encouraged to ask questions of Parker and Kuhn, who will provide an overview of existing behavioral healthcare workforce challenges; explain why America’s current workforce structure doesn’t meet present or future workforce needs; suggest redesign strategies, present examples of current successes; and offer ideas about how to leverage current options to help providers develop a more robust workforce system. Please join us and click here to register for this free webinar!

NABH 2024 Board Election Ballots Due Friday, Dec. 29!

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2024 Board. If you have not done so, please vote for the open Board Chair-Elect position and four available Board seats; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org or maria@nabh.org. NABH must receive all ballots no later than Friday, Dec. 29, 2023. New Board members and the Board Chair-elect will take office in January 2024.

SAMHSA Releases Advisory on Implementing Low-Barrier Care to Expand Access and Improve Outcomes for Individuals with SUD

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that outlines recommendations to implement low barrier models of care to significantly expand access to lifesaving treatment for individuals with substance use disorders (SUD). Despite evidence showing the effectiveness of SUD treatment, fewer than 10% of individuals who need care receive it. Barriers such as lack of treatment availability, strict program requirements, stigma, and discrimination. The advisory emphasizes the importance of low barrier care in overcoming substantial gaps in access to SUD treatment and engaging more people in care.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials. With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

The Centers for Disease Control and Prevention reports that while the provisional number of suicides in 2022 (49,449) was 3% higher than in 2021 (48,183), suicide rates for people in age groups 10–14, 15–24, and 25–34 declined 18%, 9%, and 2%, respectively, from 2021 to 2022.

Happy Holidays from NABH!

NABH will not publish CEO Update next week and will resume on Friday, Jan. 5, 2024. The entire NABH team wishes you, your families, and your teams a very happy, healthy, and safe holiday season!   For questions or comments about this CEO Update, please contact Jessica Zigmond.